• COMMENTARY

    PH must improve healthcare clinical quality and delivery system

    1

    According to the most recent World Bank report, the Philippines has been among the dynamically emerging markets in the region with its sound economic fundamentals and highly skilled workforce. Growth in the Philippines is on average about 5% since 2002, significantly higher than the rate achieved in the previous two decades. The Gross Domestic Product (GDP) country remained steady at a 7.2% growth rate in 2013, even with all the calamities. The WB report says growth momentum of the Philippines was maintained at 6% in the first half of 2014, which is one of the fastest in East Asia, surpassed only by China (7.4%) and Malaysia (6.3%). Additionally, stable remittances have also provided a strong basis for currency stability and a healthy buildup of international reserves. The country currently enjoys a savings rate that exceeds investment, while its human resources continue to be in high demand around the world.

    The percentage of the Philippines population is 34.53% for less than 15 year olds and 6. 21% for over 60 years old. Life expectancy at birth is 69 years for both sexes with males at 65 years and female at 72 years, according to World Health Organization. Economic growth here has created fiscal space for health; however significant additional financing is now available to support health reform and universal health coverage.

    The Philippines health sector is a public-private mixed system, with the private sector dominating the market. There is need for robust quality driven health systems in the Philippines addressing management of chronic diseases and better primary and referral centers as it is not only a fast growing economy, but is also blessed with an English speaking population and a healthcare force experienced in working in the most advanced healthcare systems in the world.

    Promoting healthcare related industries could be further enhanced by foreign investment; bringing foreign investment business experts, international healthcare consultants, and international accreditation agencies. Activities of all these will eventually contribute to higher GDP growth.

    With fast economics, highly trained medical professionals, internationally recognized and accredited medical centers, the Philippines could easily be a hub of medical tourism. Medical tourism will promote other potential industries such as the hotel industry, tourism, pharmaceutical and other private and public sectors.

    This is also an opportunity for Philippine hospitals and the medical community to take advantage of the falling reimbursement system and expensive healthcare in the USA and the European countries. It would be a wise decision to promote the Philippines’ medical industry in the USA and other western countries. Demand for quality medical services will be ever growing in these countries and patients will be seeking more affordable medical care abroad.

    Such services should not be limited to cosmetic surgery or expensive services for short gain, but long-term sustainable services that will benefit not only international patients also the aging Phillipine population.

    In order to address acute and chronic disease management issues, and attract investment, the Philippine hospital leadership should immediately consider the following initiatives at its upcoming meeting from November 19-21, 2014 in Manila.

    1. Hemodialysis –Quality of care on hemodialysis centers are in disarray in the Philippines. Therefore, an improvement of hemodialysis centers should be facilitated by adaptation of Disease Prevention Programs with internationally accepted Key Performance and Infection Control Indicators. There is an immediate need of reassessment of all hemodialysis centers in the country especially after the bad healthcare related outcome already reported at National Kidney Center.

    2. Patient-Centered Medical Homes (PCMH) – In order to obtain a successful outcome in cost utilization, population health, prevention, access to care and patient satisfaction, establishment of PCMH must be considered by the hospital leadership. PCMH is a patient-centered program based on a comprehensive, team-based, coordinated, accessible initiatives focused on quality and safety. It is also well practiced in the USA. It is a model for achieving primary care excellence so that care is received in the right place, at the right time, and in the manner that best suits a patient’s needs.

    3. Occupational Medicine Services – For corporate clients and international investors there is an immediate need to upgrade occupational health services, especially in the urban areas. Need for such services will constantly increase as more investments and new projects will be built in the Asia Pacific region by international firms.

    4. Leadership Development & Quality Institute: There is also a need for the establishment of the Quality Institute similar to the US Hospital Association Quality Institute. This program provides ongoing education to the hospital leadership on quality, patient safety and hospital management.

    5. Long term Acute Care Hospital (LTACH): There is also a need for introducing the concept of LTAC hospitals in the healthcare market in the Asia Pacific. Long-term acute care hospitals (LTACHs) are facilities that specialize in the treatment of patients with serious medical conditions that require continuing care but no longer require intensive care or extensive diagnostic procedures. LTACHs often are housed within the walls of an acute care hospital but function independently. LTACHs are able to provide more cost-effective care than if these same patients were kept in acute-care facilities. The types of procedures typically seen in LTACHs include prolonged ventilator use or weaning, ongoing dialysis for chronic renal failure, intensive respiratory care, multiple IV medications or transfusions, complex wound care/care for burns etc. This is a successful business module for providing management to prolonged chronic disease. Also, LTACHs could be utilized as the reference center from other hospitals in the region.

    I hope the above proposals for healthcare quality will be considered by the Asian Hospital Foundation/Philippines Hospital Association at its forthcoming meetings and that it will have full political and international support in the implementation of these initiatives.

    Ashraf A Khan, MD, MPH, MBA, is a Healthcare Consultant in Princeton, New Jersey, USA. Contact him at drashrafkhan@cgmiusa.com.

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    1 Comment

    1. If those numerous infrastructures built during the administration of then President Marcos such as : the Philippine Eye Center, Philippine kidney Center, Philippine Heart Center and Philippine General Hospital, and gov’t. hospitals were not neglected and properly maintained, many Filipinos today especially those impoverished poor who cannot afford the high charges of private hospital who caters only to those Filipinos who has money, will have hospitals to go to, that will take care of them,whenever they get sick. The blame solely lies on those corrupt politicians who purportedly abandon those hospitals for personal gain rather than to help and serve the people who elected them into where they are now. .